Six month nonunion tibial diaphysis osteotomy treated with conventional pulsed therapeutic ultrasound: a case report
Autor: | Ricardo S. Guerra, Mariana C. Ventura, Carlos Eduardo Pinfildi |
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Rok vydání: | 2021 |
Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty medicine.medical_treatment Nonunion Pain Physical Therapy Sports Therapy and Rehabilitation Bone healing Osteotomy External fixation Tibial diaphysis Humans Medicine Retrospective Studies Therapeutic ultrasound business.industry Ultrasound Middle Aged musculoskeletal system medicine.disease Gait Surgery Tibial Fractures Treatment Outcome Ultrasonic Waves Fractures Ununited Quality of Life Diaphyses business |
Zdroj: | Physiotherapy Theory and Practice. 38:3233-3240 |
ISSN: | 1532-5040 0959-3985 |
Popis: | Background: a large tibial defect significantly increases the chances of nonunion fractures, changes in the quality of life, and pain. Tibial osteotomy with a large gap size is an unfavorable condition to complete healing. Purpose: to describe the treatment of a complex case of a six-month nonunion tibial diaphysis osteotomy using conventional pulsed ultrasound therapy (cput). Case description: a 46-year-old man, 1.65 m tall, weighing 63 kg, and homeless was diagnosed with a nonunion tibial diaphysis fracture and underwent osteotomy of the tibial diaphysis with an opening gap and external fixation with circular rings and thin wires (ilizarov). An interdisciplinaty approach including social work, nutrition, and physiotherapy including exercise reconditioning was initiated over a period of two years. After six months of nonunion following a tibial osteotomy, cput was used with a frequency of 1 mhz, duty cycle of 20%, spatially averaged temporally averaged (sata) intensity of 0.1 w/cm2, frequency of 100 hz, 20 min of duration, for 2-3 times for 20 weeks. Outcomes: there was an improvement in the amount of bone in the fracture gap with a total restoration of function, resolution of pain, and gait without crutches after 35 sessions of cput. Conclusion: an interdisciplinary approach including mechanical stimulus from cput assisted in the healing process in a patient with chronic tibial osteotomy nonunion. |
Databáze: | OpenAIRE |
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